Navigating the costs of prescription drugs can be challenging, especially when living on a fixed income. However, there’s good news—Medicare offers a program that can provide extra help with these expenses. This program, known as the Low-Income Subsidy (LIS) or “Extra Help,” is designed to assist Medicare beneficiaries in covering prescription drug costs. Understanding how this program works and how you can qualify could make a significant difference in managing your healthcare expenses.
What is the LIS Program?
The Low-Income Subsidy (LIS) program, commonly referred to as “Extra Help”, is a federal assistance program that helps eligible Medicare beneficiaries pay for their Medicare Part D prescription drug plan costs. These costs can include monthly premiums, annual deductibles, and copayments. Depending on your income and resources, the program may cover a substantial portion of these costs or, in some cases, all of them. Learn more about how Extra Help can assist with drug costs.
Who Qualifies for Extra Help?
Eligibility for the Extra Help program is based on your income and resources. As of 2024, to qualify for full benefits, your annual income must be below $22,590 for an individual or $30,660 for a married couple living together. Your resources, which include savings, investments, and real estate (other than your primary residence), must also be below specific limits—$17,220 for an individual and $34,360 for a married couple. The partial subsidy option has been eliminated in 2024, and eligibility for the full subsidy has been expanded to include individuals with incomes up to 150% of the Federal Poverty Level. Find out more about Extra Help eligibility and benefits.
How Does the Program Work?
Once you’re approved for Extra Help, the program will automatically apply the benefits to your Medicare Part D plan. This can reduce or eliminate your monthly premiums, lower your deductible, and decrease your out-of-pocket costs for prescription drugs. Additionally, if you reach the “donut hole” (the coverage gap phase of Medicare Part D), Extra Help ensures you pay no more than $11.20 for each brand-name drug and $4.50 for each generic drug. There are no copays once you reach the catastrophic coverage phase. Explore how Extra Help can reduce your Medicare Part D costs.
How to Apply for Extra Help
Applying for Extra Help is straightforward. You can apply online through the Social Security Administration’s (SSA) website, by phone, or by visiting your local SSA office. You’ll need to provide information about your income and resources, so it’s helpful to have financial documents on hand when applying. The application process is confidential, and your information will only be used to determine your eligibility for the program. If you’re already enrolled in Medicaid, Supplemental Security Income (SSI), or a Medicare Savings Program, you may automatically qualify for Extra Help and won’t need to apply separately. The SSA will notify you if you qualify. Apply for Extra Help with Medicare Part D.
Why Consider Applying for Extra Help?
The Extra Help program is a lifeline for many Medicare beneficiaries struggling with high prescription drug costs. If you qualify, you could save hundreds or even thousands of dollars each year. Even if you’re unsure whether you meet the eligibility requirements, it’s worth exploring the possibility. The savings could be substantial, allowing you to better manage your overall healthcare costs and improve your quality of life. Cut your Medicare prescription drug costs with Extra Help.
Prescription drug costs can be a significant burden, but the Extra Help program offers a valuable resource to ease this burden. By understanding the LIS program, determining your eligibility, and applying for the assistance you deserve, you can take a proactive step in managing your healthcare expenses more effectively.
To learn more about Medicare programs like Extra Help and other ways to manage your healthcare costs, consider taking a class on Medicare through GetSetUp. Our classes are designed to provide you with the knowledge and confidence you need to navigate Medicare and make informed decisions about your health.
Reviewed By: Keith Gilbert